February 26, 2021

Weekly line: America's vaccine rollout has been chaotic. (But other nations have done even worse.)

Daily Briefing

By Ashley Antonelli

    By Ashley Fuoco Antonelli, senior editor

    America's Covid-19 vaccine rollout got off to a slower-than-expected start, and many Americans have reported barriers to and inequities in accessing the vaccines. But experts say that, from a global perspective, the United States is doing better than most nations at distributing the vaccines—and the U.S. effort is poised for great improvement.

    Slide deck: 'Stay Up to Date' on 'vaccine hunters,' rollout progress, and more

    Here's what you need to know about the setbacks and successes of America's Covid-19 vaccine rollout so far—and what to expect in the coming months.

    Why America's vaccine rollout has been troubled

    Last year, former President Donald Trump's administration set a goal of vaccinating at least 20 million Americans by 2020's end. However, Covid-19 vaccine distribution throughout the United States kicked off more slowly than federal officials expected, and the country didn't reach that milestone.

    A few factors contributed to the lag. For one, manufacturing of the United States' two authorized Covid-19 vaccines—one produced by Pfizer and BioNTech and the other produced by Moderna—has progressed more slowly than expected, and America quickly depleted its initial supply of the vaccines.

    Another factor is the unprecedented logistical challenge of distributing, scheduling, and administering Covid-19 vaccines, especially when paired with "fragmented chain[s] of communication between federal authorities dispatching doses and the local sites" administering the vaccines, the Wall Street Journal reports. According to the Journal, vaccine administrators at the outset generally were "in the dark about how many patients they could schedule" for vaccine appointments, and "some hospitals and health departments," concerned about supply limitations, "held back doses to make sure they had enough to administer second shots for staff or to meet appointments, creating a bottleneck."

    A further issue that contributed to a perception of chaos is that the federal government and states have taken steps to expand the number of Americans eligible for the vaccines, despite initial supply shortages. That's led to demand for the vaccines increasingly outpacing supply, with some states ultimately having to cancel vaccine appointments.

    According to experts, these issues stemmed in part from a lack of federal coordination. As the Journal reports, the "Trump administration invested heavily in rapid vaccine development, but it left the last mile of getting shots into arms to states and localities. That approach resulted in multiple, sometimes contradictory systems, and failed to ensure local sites had information about vaccine shipments that they needed to quickly administer shots."

    And according to TIME, those issues "were compounded by a lack of funds and a health care workforce already overwhelmed with Covid-19 testing, contact tracing, and pandemic-control campaigns." In fact, even when vaccination sites have doses available, they don't always have enough staff to administer the shots, the Journal reports.

    Although vaccination rates have picked up, they haven't reached the pace that many officials had hoped the country would be seeing. As things stand, about 6.5% of the United States' population has been fully vaccinated against Covid-19, with providers now administering about 1.5 million doses per day. At that rate, the United States is on track to have 50% of the country vaccinated by Aug. 1, The Week's Damon Linker notes, which is far below the 70% or higher threshold that public health experts often tout for the country to reach herd immunity.

    And, broadly, Americans aren't pleased with the vaccine rollout so far. According to a recent Gallup poll of 4,098 U.S. adults, 66% of respondents said they were dissatisfied with the rollout, including 21% who said they were "very dissatisfied."

    Even so, the vaccine rollout is going better in America than elsewhere

    On a global scale, however, the United States' vaccine rollout is actually faring better than most other countries' efforts, data suggests.

    Linker notes that, according to data, "[t]he United Kingdom is doing a little better than" the United States when it comes to vaccination rates, "[b]ut the European Union is doing far, far worse, with vaccinations proceeding last week at roughly one-fifth the U.S. rate." Linker adds, "Only Israel truly puts [the United States] to shame," with Israel having 32% of its population fully vaccinated as of last week. Linker notes, however, that Israel has a much smaller population and a much more centralized government than the United States, which could in part account for its quicker progress on vaccinations.

    Overall, the United States has administered more Covid-19 vaccine doses than any other country, Axios' Dave Lawler writes, and the country has administered more first doses of the vaccines—as measured by a percentage of its population—than every country except Bahrain, Israel, the Seychelles, the United Arab Emirates, and the United Kingdom.

    According to Lawler, the United States has several "major advantages over most of the world" when it comes to rolling out Covid-19 vaccines. For instance, "[n]ot only does America have the money to reserve more doses than it could possibly use, it also has the capacity to manufacture them domestically," Lawler writes. And "[d]espite crumbling infrastructure and chaotic politics, the [United States] remains a scientific, technological, and manufacturing powerhouse," Lawler notes.

    Improvement on the horizon?

    Further, public health experts and officials expect that America's vaccine rollout could improve significantly in coming months.

    Among the reasons for their optimism:

    1. Pharmaceutical companies are scaling up production of Covid-19 vaccine doses, and FDA is poised to authorize additional Covid-19 vaccines for use in the United States;
    2. The Biden administration has made significant investments in securing more vaccine doses and distributing them to more providers and organizations that can administer the vaccines;
    3. Federal, state, and local governments are launching efforts to increase the number of people available to staff vaccination sites and administer the shots; and
    4. Federal, state, and local governments are learning from their early missteps and investing in new resources to simplify and speed up their vaccination efforts.

    Last week, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to the White House's Covid-19 response, said he believes the United States will see "a sharp escalation in the number of people that get vaccinated and very little wait for people to get vaccinated" starting this spring. He added that Americans should see a substantial increase in Covid-19 vaccine availability in "late May and early June" of this year.

    And Biden predicted that every American who wants to get vaccinated against Covid-19 will be able to do so "[b]y the end of July this year"—though he later clarified that the United States should have enough doses "available" for every American who wants to get vaccinated by the end of July. Despite the clarification, however, Biden said he does not believe there will be significant delays in getting those doses administered.

    Ultimately, if Biden's prediction comes to fruition, the United States would "likely be far ahead of nearly every other large country, including China," when it comes to vaccinating residents as quickly as possible, Lawler writes. And while that doesn't change the fact that "America's vaccine rollout has been imperfect, unequal, and at times deeply frustrating," as Lawler notes, a global perspective highlights the advantages Americans have when compared to people living in many other countries.

    "[L]ook around the world and it's clear that it could be going a whole lot worse," he writes.

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